The objectives of the proposed study are to design, support and facilitate change that, according to evidence from the National Pressure Ulcer Long-Term Care Study (NPULS) and other published sources, is likely to lead to documented improvements in health care quality and ensure that these improvements become part of the ongoing practice of health care providers and clinicians. This project will broaden the partnerships originally established in 1996 for the NPULS to .Implement best practices in long term care. Key aims of our study are: 1 ) build partnerships to promote cooperation in Implementing quality improvement strategies In long term care facilities, 2) incorporate evidence-based best practices into everyday workflow using technology to automate data collIection, manage and track information, and support ciinicat decision-making and care planning. 3) enhance education strategies to include principles of CPt and organizational change. 4) facilitate clinical process redesign. We must redesign the process rather than just improve existlng processes. We intend to design, test, and evaluate automated processes to transmit evidence-based information and provide decision support for providers in nursing home practice. The information technology tools will enable automation of protocol-driven care: patient assessment, daily documentation flow sheets, alerts or prompts for specific interventions based on patient needs, tracking specific interventions delivered based on best practice, and summarizing documented clinical information in a variety of formats previously requiring a chart pull and abstraction. The specific objectives of this project are to: 1) Develop partnerships committed to integrating Clinical Practice Improvement study results into daily practice; 2) confirm priority improvement areas and measurable objectives; 3) Gather input from Advisory Board and Working Group to augment results of NPULS; 4) Develop implementation strategy, materials and tools for implementation, and detailed implementation plans for each participating site; 5) Facilitate implementation and sustain process; and 8) Evaluate results and develop plans for on-going initiative to expand participating sites.